Epidemiology

Cardiovascular disease (CVD) is the number one cause of death worldwide, accounting for an estimated 17.9 million deaths per year.[8] Ischemic heart disease (IHD) is the most common cause of cardiovascular death; data from the European Society of Cardiology in 2019 showed that IHD accounted for 38% of CVD deaths in females and 44% in males.[5]​[9]​​​​​

Coronary heart disease mortality has fallen over the last 30 years in Europe and is decreasing in many developed countries, but is increasing in developing and transitional countries, with more than 75% of CVD death occurring in developing countries.[8]​ These trends reflect changes in population longevity, urbanization, and lifestyle changes.[8]​ In the US, it is estimated that >800,000 people will experience an acute myocardial infarction each year.[2]

IHD is more common in men than in women.[9][10]​​​ Retrospective data from 2010 to 2016 showed that in-hospital mortality in the US was higher in females with non-ST-elevation myocardial infarction (NSTEMI) than in males (4.8% compared with 3.9%, based on unadjusted data). This difference in mortality remained after controlling for age, comorbidities, and hospital factors.[11] Epidemiology data have shown that acute coronary syndrome cases with ST-elevation myocardial infarction (STEMI) appear to be declining and that NSTEMI occurs more frequently than STEMI.[10]​ International data suggests that the incidence of NSTEMI continues to rise.[12][13]​​​​[14][15][16][17]​​​​ This is likely due to the advent of more sensitive assays for myocardial injury, earlier pharmacotherapy, and reperfusion (and prevention) of STEMI.[3]​​​​

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